Fillings wrong Fee

For users or potential users.
Post Reply
sbrugg23
Posts: 4
Joined: Thu Dec 17, 2020 11:04 am

Fillings wrong Fee

Post by sbrugg23 » Wed Apr 07, 2021 2:10 pm

When we treatment plan fillings the Allowed column is pulling the wrong fee for most of the insurances. Crowns, root canals other codes I have checked are pulling the correct fee, only fillings. I have checked the fee schedules and they are right. Example: Metlife Fee for 2 surf comp = $130, Tx plan pulls $94 in the allowed column so then all figures after that are incorrect. What is going on?

joes
Posts: 148
Joined: Tue Aug 13, 2019 12:41 pm

Re: Fillings wrong Fee

Post by joes » Wed Apr 07, 2021 2:53 pm

Many settings can affect allowed amounts. It is difficult to say what exactly is causing the problem without having one of our technicians do some troubleshooting.

A few things you can check:
1. Is the Blue Book feature turned on?
2. Are the fees in the fee schedules correct? (It sounds like you already checked this one.)
3. If the problem is for Category Percentage Plans, are the correct Out of Network fee schedules selected for them?
4. If the problem is for PPO plans, are the correct Fee Schedules selected for them?

If all of these settings seem correct, and you are still having this issue, please call support at 503-363-5432, or see our contact page for other ways to contact us, https://www.opendental.com/contact.html.
Joe Sullivan
Open Dental Software
http://www.opendental.com

sbrugg23
Posts: 4
Joined: Thu Dec 17, 2020 11:04 am

Re: Fillings wrong Fee

Post by sbrugg23 » Wed Apr 07, 2021 2:59 pm

I think we found that the Don't Substitute Codes isn't being checked. Is there a way to make that automatically checked?

joes
Posts: 148
Joined: Tue Aug 13, 2019 12:41 pm

Re: Fillings wrong Fee

Post by joes » Thu Apr 08, 2021 9:15 am

We don't currently have a way to change the default for that setting when a new insurance plan is created, but there is a feature request for that if you would like to vote on it. It is feature request #8701. Please see our manual for more details about feature requests, https://www.opendental.com/manual/featurerequests.html.
Joe Sullivan
Open Dental Software
http://www.opendental.com

sbrugg23
Posts: 4
Joined: Thu Dec 17, 2020 11:04 am

Re: Fillings wrong Fee

Post by sbrugg23 » Thu Apr 08, 2021 12:01 pm

Is that box normally checked or not? The Don't Substitute Codes button.

joes
Posts: 148
Joined: Tue Aug 13, 2019 12:41 pm

Re: Fillings wrong Fee

Post by joes » Thu Apr 08, 2021 2:52 pm

When a new insurance plan is created, the box is unchecked by default.
Joe Sullivan
Open Dental Software
http://www.opendental.com

Post Reply